IJE Advance Access originally published online on August 30, 2006
International Journal of Epidemiology 2006 35(6):1514-1521; doi:10.1093/ije/dyl197
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Article |
Risk factors for skin cancers: a nested case–control study within the Nurses’ Health Study
1 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
2 Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
3 The Program in Molecular and Genetic Epidemiology, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
* Corresponding author. Jiali Han, Channing Laboratory, Brigham and Women's Hospital, and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA. E-mail: jiali.han{at}channing.harvard.edu
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Abstract |
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Background Constitutional factors and sun exposure are associated with skin cancer risk. However, these relations are complex and differ according to skin cancer type.
Methods We examined the associations of constitutional risk factors and sun exposure with the risks of three types of skin cancer simultaneously and evaluated the interaction between constitutional susceptibility and sun exposure in a nested case–control study within the Nurses' Health Study [200 melanoma, 275 squamous cell carcinoma (SCC), and 283 basal cell carcinoma (BCC) cases, and 804 controls]. Information regarding skin cancer risk factors was obtained from the retrospective supplementary questionnaire.
Results Constitutional susceptibility was an independent risk factor for all three types of skin cancer. Sunlamp usage or tanning salon attendance was a risk factor for melanoma after adjusting for potential confounding variables (OR for ever vs never usage, 2.06, 95% CI 1.30–3.26). Higher sun exposure while wearing a bathing suit was an independent risk factor for all three types of skin cancer. We observed a significant interaction between constitutional susceptibility and sun exposure while wearing a bathing suit on melanoma risk (P, interaction, 0.03); women with the highest susceptibility and highest exposure had an OR of 8.37 (95% CI 3.07–22.84). This interaction was weaker and non-significant for SCC and BCC.
Conclusions These data largely confirm past studies on risk factors for skin cancer but provide evidence of difference on the strength of these risk factors for melanoma compared with SCC and BCC.
Keywords constitutional susceptibility, sun exposure, skin cancer
Accepted 2 August 2006
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